Isolated PCL Tear in knee, may be getting surgery soon, requesting experiences and advice please?

Triathlon Forum
1

Hello there,

I am a 25 year old male who has been physically active most of his life. Last year when running a mile, I noticed there was some instability and pain in my right knee when running. I went to two doctors and got MRIs, the second one diagnosed me with an Chronic Isolated PCL Tear. Doctor said it was around a grade 2.8 and is very close to Grade 3 tear. This probably happened a a few years ago in an accident where I tripped and landed on my right knee.

Basically the doctor gave me two options, 1. Do Physical Therapy and Strengthen your quads or 2. Get Surgery and rehab after. He recommended one first and if that did not work out, we could proceed with surgery. Well I have been doing PT for more than a year and while PT has greatly strengthened my legs and I pretty much have no pain now, I still have instability when running. It is like My right knee can’t bear any major weight so anytime I try to run or do single leg hops, it feels like it is going to give out. Other than that, I can walk just fine, swim fine, and bike fine.

I am a bit worried about the operation, my doctor has experience with PCL surgeries but unfortunately on the Internet, there is not much about PCL surgeries. I don’t want to live the rest of my life not being able to run again especially since I am still young. Other than my PCL tear in my right knee, my right knee appears to be fine with some very mild cartilage degeneration and a Tiny Bakers Cyst.

Anyone here who has gotten the surgery before and is back to running or their normal quality of life? Any help or experience is useful.

Thank you.

2

PCL tears are quite unusual, people normally do their ACLs.

I’d go with the surgery, you be out of action for 6 months, but then should be good as new (if you rehab). Have a look for ACL surgery info, it is the same op as PCL. Discuss which graft is best for you with surgeon, normally the options are hamstring or quadriceps tendon (my OH had his ACL with a quad graft).

(consider also if your knee is unstable mild cartilage degeneration my become more significant)

3

Thanks for the post, I hope the PCL recovery works well. I have been having cold feet about surgery.

4

Hello there,

I am a 25 year old male who has been physically active most of his life. Last year when running a mile, I noticed there was some instability and pain in my right knee when running. I went to two doctors and got MRIs, the second one diagnosed me with an Chronic Isolated PCL Tear. Doctor said it was around a grade 2.8 and is very close to Grade 3 tear. This probably happened a a few years ago in an accident where I tripped and landed on my right knee.

Basically the doctor gave me two options, 1. Do Physical Therapy and Strengthen your quads or 2. Get Surgery and rehab after. He recommended one first and if that did not work out, we could proceed with surgery. Well I have been doing PT for more than a year and while PT has greatly strengthened my legs and I pretty much have no pain now, I still have instability when running. It is like My right knee can’t bear any major weight so anytime I try to run or do single leg hops, it feels like it is going to give out. Other than that, I can walk just fine, swim fine, and bike fine.

I am a bit worried about the operation, my doctor has experience with PCL surgeries but unfortunately on the Internet, there is not much about PCL surgeries. I don’t want to live the rest of my life not being able to run again especially since I am still young. Other than my PCL tear in my right knee, my right knee appears to be fine with some very mild cartilage degeneration and a Tiny Bakers Cyst.

Anyone here who has gotten the surgery before and is back to running or their normal quality of life? Any help or experience is useful.

Thank you.

I’m going to go out on a limb here and say I’m the only person on here that has not only had one PCL surgery but also had a PCL revision surgery with a LCL reconstruction at the same time.

Where are you located just to see if my doctor could possible do it. I would pick him if you’re close. You can PM and I’ll get you my phone number. Probably way more than I want to try to type out.

My personal opinion is get the surgery if they are a good doctor. I can explain this more but see if they’re doing single or double bundle. If they’re double they’re probably better at the surgery because it’s more complex.

I did 5 years of competitive hockey and 10 years of pretty competitive triathlons with it torn. But it wasn’t fun. There was a lot of pain meds and injections to deal with it. But until about 10 years ago they didn’t do the surgery as a PCL only. So I didn’t have the option to do it. Even with needing to rehab twice I’d take that any day over what it was before. Also because of hockey I was on the higher end of quad strength, and you still can’t rehab it enough. You probably can if you’re not active. If you’re active and the doctor says you can rehab it and be fine, he’s kidding himself.

5

PCL tears are quite unusual, people normally do their ACLs.

I’d go with the surgery, you be out of action for 6 months, but then should be good as new (if you rehab). Have a look for ACL surgery info, it is the same op as PCL. Discuss which graft is best for you with surgeon, normally the options are hamstring or quadriceps tendon (my OH had his ACL with a quad graft).

(consider also if your knee is unstable mild cartilage degeneration my become more significant)

Both of my surgeons will not use autographs in athletes on PCLs because of the amount of tissue you have to take. The PCL band is thick enough that they don’t want to take that much muscle and it make rehab harder. For the second one where they did double bundle and LCL they definitely wouldn’t do that because that is a whole bunch of tissue.

Also just to add the op is definitely not the same, even single bundle is significantly more difficult because of the angles they need to drill the tunnels to secure the new tissue. I’m addition you just don’t see this frequently, that make it one I wouldn’t just go to anyone. If they’re saying they can do it I would see how many they have actually done. It is not an ACL surgery, isolated PCL is incredibly rare. Isolated PCL incident rate per year is less than 2 per 100k people, ACL is pushing 70/100k. It’s totally possible you could have a knee surgeon never do a PCL surgery.

6

Also just to add the op is definitely not the same, even single bundle is significantly more difficult because of the angles they need to drill the tunnels to secure the new tissue. I’m addition you just don’t see this frequently, that make it one I wouldn’t just go to anyone. If they’re saying they can do it I would see how many they have actually done. It is not an ACL surgery, isolated PCL is incredibly rare. Isolated PCL incident rate per year is less than 2 per 100k people, ACL is pushing 70/100k. It’s totally possible you could have a knee surgeon never do a PCL surgery.

Of course it’s not “exactly the same” - but for someone who has no idea about what the op involves and is looking for info, ACL reconstruction is similar enough to PCL reconstruction, that it will give them a very good idea of what they’ll go through (when there is not much PCL info).

7

I tore my ACL, PCL and MCL (with the help of a car T-boning me on the bike), requiring a multi ligament knee reconstruction. After 6 months of Physio I was training again and 10 months after the accident I was back completing my next Ironman. 6 months after that I did an Ultraman, with its double marathon.

So while my injury wasn’t exactly like yours, it’s hopefully similar enough to reassure you that surgery isn’t necessarily a bad thing. I have 5 screws holding everything together but I can do all the running I want.

All the best with your treatment.

8

I had a PCL reconstruction 12 years ago for a complete tear. 2 years ago I had a ACL reconstruction on the other knee. During the dr visits for my ACL the Dr was showing me on my repaired PCL how it had slackened over the years and said PCLs often will loosen after a reconstruction. I would have the surgery again if I had another complete tear. Only for a complete tear. Twice I have addressed partial tears in ACLs with prolotherapy. Prolotherapy has twice allowed me to rehab and strengthen both knees without surgery.

I also don’t attribute my torn ACL to previous damage that prolotherapy didn’t help heal. I tore it doing a sideways jump trying to block a 3 pointer in a pickup basketball game. I probably should of known better at 48.

If you give prolotherapy try you will be out of action for activity for 1-2 days after each injection. I believe 5-8 injections over a few weeks is the recommendation. That and the cost since it isn’t covered by insurance is the drawback. You can always choose surgery later if you wish.

Skip down to: The regenerative approach to a Posterior Cruciate Ligament injury with Prolotherapy

https://www.caringmedical.com/...l-injury-treatments/

If you do go down this path your Dr may offer the choice of saline vs oil for injection. The oil lasts longer. 2-3 days instead of 1-2. The trade off is the needle is twice the size and of course the injection is twice as painful. I took the oil the second time and I think I would choose oil again should I have another injury.

9

They sag pretty much immediately it’s one of the problems gravity haha. There is a new brace that I wore for I think for 3 months after I was out of the locking one for the last surgery. The company says daily from month 3-4 months and then during return to play until 6 months. I know I didn’t wear it that long because I had hip surgery at 3 months. I also appreciate they think you can use that in return to play, but that is kinda a joke unless your return to play is like golf or something. There is no way you could run/bike etc in it and be comfortable. My doctor wasn’t concerned at least.

https://assets.ossur.com/library/39566/Rebound%20PCL%20Catalog%20page%20-%202018.pdf

The brace is stupidly expensive but was luckily covered by my insurance. When you bend your knee it actually pushes the tibia forward causing it to stay in the correct position to heal and not sag. Mine is definitely more stable than after the first surgery, but I also probably had a torn LCL when they did the first one and they only did single bundle the first time so who knows what the main driving factor was on it feeling better.

10

Appreciate the advice, I will get surgery.

11

Thanks for the post! A post like this gives me hope! Glad you are doing better!

12

Injection sound expensive unfortunately.

13

Like I said reach out if you ever have questions or what not glad to talk about it. I honestly didn’t think the PCL surgery was that bad. When they had to redo and do the LCL that was the worst one I have every had but that’s because the LCL isn’t arthroscopic.